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06-104737cry OF EC Federal Wa EIVED PERMIT C0MMUM9YDSVBLOPMBNTSVWC63 3332 S 8TM AVBNUB SOVRf • PO BOl,9M .1 9 zoos P P LI C AT I O N PBDBRAL WAY, WA 98063-9717 �.' 753-d3SZ6p7• PAX T53-835.2609 wuw dtuoM /°&°"""`'•i OF FEDERAL WAY Q=r1 SF MF CO ME EL PL DE EN will not be accepted. Please or SITE ADDRESS 5-3 � rj 5 W 11 E (,AC- SUITE/UNIT # ASSESSOR'S TAX/PARCEL # l��-L Q - _0 © 5 LOT SIZE (sj LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) 14G—Aue PA u5 A DE -s. jjL,V= l LO T =k A IAS �a�la►�w tyara PROJECT• • TYPE OF PERMIT ❑ BUILDING . ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING.)(FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlul De's IeLQ FOND 1 NSTk-L.L- �( Dg7j PROJECT NAME (Name of Business or Owner Last Name) V—n4 PIETS ( pg 0 Cio- PEOPLE•- • PROPERTY OWNER CONTRACTOR APPLICANT CONTACT LENDER NAME PRIMARY PHONE S e.N PT0 f'e (as3) 48 - 8148 MAILING ADDRESS CITY, STATE, ZIP a17 MEEIAPtJ E COMPANY NAME W AS W_I_ APPLICANT NAME N ©t'� SPI N,V � OFFICE PHONE (Zs� �1- CELL PHONE eS3 `cn-7—%3+ 76 MAILINO ADDRESS JC M6P%I) A N 6, CITY, STATE, ZIP Gtg 3 1 CrWOOD W 1 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATIO DATE/1 - Q--[ Q I_ 8+Z -B 1Z/ 1 /Oro FAX NUMBER Q 25+1 4S L' .(24 CONTRACTORS REGISTRATION NUMBER copy of card required with each application) EXPIRATION DATE i i vi A7 �E=Fr- r- s 1Z-P(a C N Y QM fl 0 I NE (Z.Sa ISAI " 70 (II S NAME MAILING ADDRESS CITY, STATE, ZIP PHONE EXISTING USE PROPOSED USE IZCS 1 D-E� PTI 41 A@7 EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK Q SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED%REQUIRED? RYES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN . ❑ HIGHLINE 0 PRIVATE (SEPTIC) Mq oT J NET 0 a AREA DESCRIPTION EXISTING PROPOSED SQ. FT. SQ. FT. TOTAL SQ. FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS (DESCRIBE) DECK(COVERED7) GARAGE XCARPORT 0 NUMBER OF FLOORS X10 0f1O�iD TOTAL "7-70 r7* 7 O "NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLIM 3 PRICE $ Indicate Value of Mechanical Work _ AIR HANDLING UMTS BBQS _ BOILERS _ COMPRESSORS DUCTS PLUMBING BATHTUBS (er Tth/shover Compo) DISHWASHERS GAS PIPE OUTLETS WASHINO MACHINES LAVS mArhroom swul or EVAPORATIVE COOLERS FANS FIREPLACE INSERTS FURNACES GAS PIPE OUTLETS SHOWERS SINKS SUMPS URINALS VACUUM BREAKERS as part of this project. Do not GAS LOGS HOODS (cemmoretoq RANGES GAS WATER HEATERS WATER CLOSETS p'o&o _ DRINKING FOUNTAINS RAINWATER SYST HOSE BIBBS ELECTRIC WATER HEATERS REFRIG. SYSTEMS MISC (Describe) I cert{fy under penalty of perjury that the irv% mation furnished by me is true and correct to the best of my knowledge, and further, that I am authorised by the owner of the above premises to. perform the work for which the permit application is .made. I further agree to hold harmless the City of Federal Way as to any claim [including costs, expenses, and attorneys' fees incurred in the investigation and defense of such claim, which may be made by any person, including the undersigned, and filen against the City of Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE RELATIONSHIP TO PROJECT a Ownereat o Contractor I] Architect I] Other t bA" D....e 7 «OA L\Lr....A....a.\De..«:♦ A....1:..«♦;..«